Skip to main content

Advertisement

SpringerLink
Log in

Incidence of chemotherapy-induced amenorrhea in premenopausal patients with breast cancer following adjuvant anthracycline and taxane

  • Original Article
  • Published:
Breast Cancer Aims and scope Submit manuscript

Abstract

Background

The purpose of this study was to determine the incidence of amenorrhea among breast cancer patients aged 40 years and younger following adjuvant chemotherapy.

Methods

A follow-up questionnaire survey was conducted with premenopausal women with breast cancer who were treated with adjuvant anthracycline and taxane-based chemotherapy.

Results

In total, 66 women were retrospectively reviewed. Forty-nine patients were treated with a regimen containing anthracycline followed by taxane and 17 patients with anthracycline alone. Fifty-eight patients (87.9%) experienced amenorrhea during chemotherapy; 14 patients (21.2%) had persistent amenorrhea after chemotherapy. The incidence of amenorrhea during chemotherapy and persistent amenorrhea was higher in patients older than 36 than in younger patients (97.9 vs. 63.2%, 27.7 vs. 5.3%). Additional taxane resulted in a higher incidence of amenorrhea compared with anthracycline-containing regimen alone (93.9 vs. 70.6%). Multivariate analysis showed that age (≥36 years) was independently associated with the incidences of amenorrhea during chemotherapy (p = 0.007).

Conclusion

Age was the strongest predictor of the incidence of amenorrhea during chemotherapy. It is unclear whether additional taxane may contribute to amenorrhea. This information could be useful in deciding whether to use adjuvant chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Early Breast Cancer Trialists’ Collaborative Group. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;365:1687–1717.

    Google Scholar 

  2. Bines J, Oleske DM, Cobleigh MA. Ovarian function in premenopausal women treated with adjuvant chemotherapy for breast cancer. J Clin Oncol. 1996;114:1718–29.

    Google Scholar 

  3. Partridge AH, Gelber S, Peppercorn J, Sampson E, Knudsen K, Laufer M, et al. Web-based survey of fertility issues in young women with breast cancer. J Clin Oncol. 2004;22:4174–83.

    Article  PubMed  Google Scholar 

  4. Early Breast Cancer Trialists’ Collaborative Group. Ovarian ablation in early breast cancer: Overview of the randomised trials. Lancet. 1996;348:1189–96.

    Google Scholar 

  5. Pagani O, O’Neill A, Castiglione M, Gelber RD, Goldhirsch A, Rudenstam CM, et al. Prognostic impact of amenorrhoea after adjuvant chemotherapy in premenopausal breast cancer patients with axillary node involvement: results of the International Breast Cancer Study Group (IBCSG) Trial VI. Eur J Cancer. 1998;34:632–40.

    Article  PubMed  CAS  Google Scholar 

  6. Bianco AR, Del Mastro L, Gallo C, Perrone F, Matano E, Pagliarulo C, et al. Prognostic role of amenorrhea induced by adjuvant chemotherapy in premenopausal patients with early breast cancer. Br J Cancer. 1991;63:799–803.

    Article  PubMed  CAS  Google Scholar 

  7. Warne GL, Fairley KF, Hobbs JB, Martin FI. Cyclophosphamide-induced ovarian failure. N Engl J Med. 1973;289:1159–62.

    Article  PubMed  CAS  Google Scholar 

  8. Hortobagyi GN, Buzdar AU, Marcus CE, Smith TL. Immediate and long-term toxicity of adjuvant chemotherapy regimens containing doxorubicin in trials at MD Anderson Hospital and Tumor Institute. NCI Monogr. 1986;1:105–9.

    PubMed  Google Scholar 

  9. Swain SM, Land SR, Ritter MW, Costantino JP, Cecchini RS, Mamounas EP, et al. Amenorrhea in premenopausal women on the doxorubicin-and-cyclophosphamide-followed-by-docetaxel arm of NSABP B-30 trial. Breast Cancer Res Treat. 2009;113:315–20.

    Article  PubMed  CAS  Google Scholar 

  10. Goldhirsch A, Gelber RD, Castiglione M. The magnitude of endocrine effects of adjuvant chemotherapy for premenopausal breast cancer patients: the International Breast Cancer Study Group. Ann Oncol. 1990;1:183–8.

    PubMed  CAS  Google Scholar 

  11. Goodwin PJ, Ennis M, Pritchard KI, Trudeau M, Hood N. Risk of menopause during the first year after breast cancer diagnosis. J Clin Oncol. 1999;17:2365–70.

    PubMed  CAS  Google Scholar 

  12. Walshe JM, Denduluri N, Swain SM. Amenorrhea in premenopausal women after adjuvant chemotherapy for breast cancer. J Clin Oncol. 2006;24:2651–8.

    Article  Google Scholar 

  13. Han HS, Ro J, Lee KS, Nam BH, Seo JA, Lee DH, et al. Analysis of chemotherapy-induced amenorrhea rates by three different anthracycline and taxane containing regimens for early breast cancer. Breast Cancer Res Treat. 2009;115:335–42.

    Article  PubMed  CAS  Google Scholar 

  14. Berliere M, Dalenc F, Malingret N, Vindevogel A, Piette P, Roche H, et al. Incidence of reversible amenorrhea in women with breast cancer undergoing adjuvant anthracycline-based chemotherapy with or without docetaxel. BMC Cancer. 2008;8:56–64.

    Article  PubMed  Google Scholar 

  15. Henderson IC, Berry DA, Demetri GD, Cirrincione CT, Goldstein LJ, Martino S, et al. Improved outcomes from adding sequential paclitaxel but not from escalating doxorubicin dose in an adjuvant chemotherapy regimen for patients with node-positive primary breast cancer. J Clin Oncol. 2003;15:976–83.

    Article  Google Scholar 

  16. Martin M, Pienkowski T, Mackey J, Pawlicki M, Guastalla JP, Weaver C, et al. Adjuvant docetaxel for node-positive breast cancer. N Engl J Med. 2005;352:2302–13.

    Article  PubMed  CAS  Google Scholar 

  17. Tham YL, Sexton K, Weiss H, Elledge R, Friedman LC, Kramer R. The rates of chemotherapy-induced amenorrhea in patients treated with adjuvant doxorubicin and cyclophosphamide followed by a taxane. Am J Clin Oncol. 2007;30:126–32.

    Article  PubMed  CAS  Google Scholar 

  18. Fornier MN, Modi S, Panageas KS, Norton L, Hudis C. Incidence of chemotherapy-induced, long-terme amenorrhea in patients with breast carcinoma age 40 years and younger after adjuvant anthracycline and taxane. Cancer. 2005;104:1575–9.

    Article  PubMed  CAS  Google Scholar 

  19. Davis L, Klitus M, Mintzer D. Chemotherapy-induced amenorrhea from adjuvant breast cancer treatment: the effect of the addition of taxanes. Clin Breast Cancer. 2005;6:421–4.

    Article  PubMed  CAS  Google Scholar 

  20. Abusief ME, Missmer SA, Ginsburg ES, Weeks JC, Partridge AH. The effects of pacritaxel, dose density, and trastuzumab on treatment-related amenorrhea in premenopausal women with breast cancer. Cancer. 2010;116:791–8.

    Article  PubMed  CAS  Google Scholar 

  21. Reh A, Oktem O, Oktay K. Impact of breast cancer chemotherapy on ovarian reserve: a prospective observational analysis by menstrual history and ovarian reserve markers. Fertil Steril. 2008;90:1635–9.

    Article  PubMed  CAS  Google Scholar 

  22. Di Cosimo S, Alimonti A, Ferretti G, Sperduti I, Carlini P, Papaldo P, et al. Incidence of chemotherapy-induced amenorrhea depending on the timing of treatment by menstrual cycle phase in women with early breast cancer. Ann Oncol. 2004;15:1065–71.

    Article  PubMed  CAS  Google Scholar 

  23. Bordeleau L, Pritchard K, Goodwin P, Loprinzi C. Therapeutic options for the management of hot flashes in breast cancer survivors: an evidence-based review. Clin Ther. 2007;29:230–41.

    Article  PubMed  CAS  Google Scholar 

  24. Leining MG, Gelber S, Rosenberg R, Przypyszny M, Winer EP, Partridge AH. Menopausal-type symptoms in young breast cancer survivors. Ann Oncol. 2006;17:1777–82.

    Article  PubMed  CAS  Google Scholar 

  25. Nystedt M, Berglund G, Bolund C, Fornander T, Rutqvist LE. Side effects of adjuvant endocrine treatment in premenopausal breast cancer patients: a prospective randomized study. J Clin Oncol. 2003;21:1836–44.

    Article  PubMed  CAS  Google Scholar 

  26. Gerber B, Stehle H, Ricardo F, Maass N, Fischer D, Sommer HL et al. A prospective randomized multicenter study to prevent chemotherapy-induced ovarian failure with the GnRH-agonist goserelin in young hormone-insensitive breast cancer patients receiving anthracycline containing (neo-) adjuvant chemotherapy (GBG 37). J Clin Oncol. 2009;27:Abstr No. 526.

  27. Burger HG. The endocrinology of the menopause. Maturitas. 1996;23:129–36.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, Japan

    Yuko Okanami, Yoshinori Ito, Chie Watanabe, Nahomi Tokudome, Shunji Takahashi & Kiyohiko Hatake

  2. Department of Breast Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, Japan

    Kotaro Iijima & Takuji Iwase

  3. Department of Pathology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, 216-8511, Japan

    Yuko Okanami

Authors
  1. Yuko Okanami
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoshinori Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chie Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kotaro Iijima
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takuji Iwase
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nahomi Tokudome
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shunji Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kiyohiko Hatake
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yuko Okanami.

About this article

Cite this article

Okanami, Y., Ito, Y., Watanabe, C. et al. Incidence of chemotherapy-induced amenorrhea in premenopausal patients with breast cancer following adjuvant anthracycline and taxane. Breast Cancer 18, 182–188 (2011). https://doi.org/10.1007/s12282-011-0256-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12282-011-0256-7

Keywords

Search

Navigation